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虚拟调节患者的数字双胞胎,以预测心脏再同步治疗后左心室逆转重塑

Tijmen Koopsen¹, Willem Gerrits², Nick van Osta¹

¹Department of Biomedical Engineering, CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 40, 6200 MD, The Netherlands.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

|January 30, 2024

概括

数字双胞胎准确地预测心力衰竭患者对心脏再同步治疗 (CRT) 的反应. 数字双胞胎的虚拟节奏显示了优化CRT患者选择和治疗的潜力.

科学领域:

心脏病学心脏病学
生物医学工程生物医学工程
计算医学是一种计算医学.

背景情况:

鉴定心力衰竭 (HF) 患者从心脏再同步治疗 (CRT) 中受益,对于有效治疗至关重要.
目前用于预测CRT响应的方法存在局限性,需要新的方法.

研究的目的:

评估虚拟节奏在患者特定的数字双胞胎 (DT) 中的有效性,以预测CRT后左心室 (LV) 反向重塑.
评估DT衍生参数是否可以识别可能受益于CRT的高压患者.

主要方法:

四十五名接受CRT的HF患者被追溯分析.
使用基线心声学和CircAdapt模型创建了针对患者的数字双胞胎.
在DTs中模拟了虚拟双心室节奏,以导出隔膜到侧面心肌工作差异 (MWLW-S,DT) 和dP/dtmax,DT.
计算了DT衍生参数与CRT后实际LV末缩体积变化 (ΔLVESV) 之间的相关性.

主要成果:

无论是基线MWLW-S,DT还是虚拟节奏诱导的ΔMWLW-S,DT都与现实世界的ΔLVESV显著相关 (r = -0.60和r = 0.62,分别;P < 0.001).
ΔdP/dtmax,DT 和 ΔLVESV 的相关性较弱 (r = -0.34,P = 0.02).
通过DT预测的反向改造中的虚拟步调来减少隔膜到侧面工作失衡.

结论:

数字双胞胎虚拟节奏有效预测心力电图后的心脏衰竭患者的LV反向重塑.
这种DT方法为增强CRT患者选择和优化治疗交付提供了一个有前途的工具.

关键词:

在 silico 临床试验中.电路自适应器的电路自适应器计算机建模和模拟.左捆的分支区块的分支区块.心肌功能的工作.针对患者的具体建模

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